written by: LauraLMSW
• edited by: Amanda Grove
• updated: 5/27/2015
Children with traumatic brain injuries require alternative approaches to teaching and learning. The more aware and informed people can be about the results of traumatic brain injuries, the better prepared they will be to be compassionate responders. Families dealing with TBI need not feel isolated.
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Strong Education Focus
The Brain Injury Association of New York State created LearNet, which is a resource for teachers, clinicians, parents and students. This website is an asset because it provides access to specialists and consulting services for free. The website is user friendly and appropriate for all ages. Accessible resources are extensive and supported by evidence-based research.
A resource guide available through the website, “Traumatic Brain Injury: A Guidebook for Educators," highlights general information, special considerations, strategies and approaches. The Brain Injury Association of New York State has many additional publications exemplifying the available wealth of information.
LearNet offers extensive lists of “problems seen," which are categorized for school, home and in social life. After selecting an evident problem the general medical, cognitive/self-regulatory, behavioral and social-emotional possibilities are explained in depth. If one of the suggested potential problems sounds familiar, tutorials are provided to guide the user through the necessary considerations and actions. The tutorials instruct on assessment issues, family issues, and physical issues.
An educational example of a problem seen is “The student appears to need directions repeated; he often does not do what he is supposed to do; he either does not begin or does not complete assignments; he may at times appear to be defiant." Lists of possible explanations designate observations and experiments to determine the sources of the problem from one of the four possibilities previously listed.
For this example, general medical possibilities include medication side effects, chronic pain, fatigue, hunger, hearing impairment and seizures. Identified cognitive/self-regulatory possibilities include initiation impairment, weak orientation to task, organizational impairment, attention deficit and inhibition impairment. Behavioral possibilities are oppositionality, attention seeking, manipulativeness and task avoidance. Social-Emotional problems could be depression, anxiety or frustration. Each of these possibilities are then examined further to rule out or focus in on impairments.
Consider weak cognitive and academic functioning. Halgin and Whitbourne (2003) said that people who have traumatic brain injury typically develop amnesia and persisting memory problems. On the provided tutorial, LearNet states that following TBI both encoding and retrieval can be significantly impaired but storage is often relatively spared. Notice the difference in outlook provided by a textbook versus LearNet which is a source of scientifically supported hope and guidance. LearNet expands on this point by saying that if information can be effectively processed and encoded; it is more likely to be retained even though it may be difficult to retrieve. The possibility of retention should not be diminished because it is the first step. In order to retrieve information, it must be retained. Taking small steps and realizing typical TBI processes bolsters the active search toward rehabilitation and recovery.
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LearNet also has outlined self-regulation scripts to help children in a variety of daily living tasks. Along with step-by-step instructions, a video illustration demonstrates each script.
Common symptoms of traumatic brain injury include sensory and motor deficits, language disturbance, attentional problems, irritability, anxiety, emotional upheaval, increased aggression and other personality changes (Halgin & Whitbourne, 2003). These symptoms challenge the success of children. LearNet scripts follow a format that identifies or labels the issue, states the reason, offers a strategy and offers general reassurance.
Examples of available scripts include problem-solving/strategic behavior, hard to do/easy to do, ready/not ready, big deal/little deal, scary/not scary and choice/no choice. Practicing and viewing scripts can lead to strengthened self-awareness and confidence. Children with traumatic brain injuries may become frustrated as their failed attempts at basic functioning increase. Traumatic brain injury symptoms can create feelings of hopelessness and lack of control. The utilization of scripts provides helpful, nonjudgmental opportunities to relearn or increase control over life skills often taken for granted.
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Special Education Guide
Traumatic Brain Injury Resources are featured on Parentpals.com, a special education guide that is now available on the website of Washington University. The site includes education, books, general information, treatment, products, organizations, articles and message boards.
Featured special education articles include, "Communication vs. Conflicts: Helping Parents and Educators," “Frequently Asked Questions about Brain Injury In Children" and “When a Child has a Brain Injury." These articles address commonly encountered conflict between parents and educators. Tips are provided for educators to help parents develop and understand an adequate IEP. Marilyn Lash, a contributing master social worker, described the need for additional support, “Already emotionally traumatized by their child’s brain injury and exhausted by the hospital vigil, families entering negotiations with the school system are frequently ill prepared." Healthy communication is facilitated by the information and suggestions offered through featured article topics such as, “Tips for educators on communicating when a parent is angry" and “Educating parents about special education." When educators and parents are informed about the needs and rights of children with traumatic brain injuries, they are better able to serve them in the classroom.
Lashes featured articles on Parentpals.com emphasize the importance of accurate classification under special education. Previously, many students with brain injuries were erroneously described as mentally retarded, learning disabled or emotionally disturbed. Brain injuries create trauma specific consequences that will impact learning, behavior and communication. Lash said that identifying the student accurately under the classification of traumatic brain injury helps educators recognize the condition and it consequences so that they can then develop educational strategies and programs that are individually designed for that student. When educators implement student specific modifications and planning, they help to create the most appropriate and functional adjustments.
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Returning to School After Brain Trauma Occurs
The Brain Injury Recovery Network is described as a site that provides practical, actionable advice for brain injury victims and families distinguished by crisis phase and long term phase. The mission of the site is stated as, “Our goal is to see that victims of brain injuries are given every possible chance to recover."
When a child has missed school due to the trauma causing injury, there are key actions that both parents and schools should take to ensure the smoothest transition back into the school possible. The Brain Injury Recovery Network recommends a meeting between parents and school officials to create an opportunity to learn about what services are available and what school policies are. Learning plans can be established if a child will need tutoring, extended test taking time, tape recording and other accommodations. School employed speech and occupational therapists might be a potential source of additional support during the child’s return to school. The site stresses that additional concerns stem beyond the curriculum into the social world. The dynamics are differentiated based on injury severity and age. It is recommended that classrooms with young children are given explanations of what happened, what to expect and how to relate to the child. If the student is in high school, their friends should be notified and talked to prior to the return so that they can watch out for their friend. The site advises that college aged students and their families will need to visit the school’s office of disabilities to learn the set policies and guidelines. College level courses often provide note-takers, special exams, computer modifications or other accommodations.
The “Back to School" advice also offers personal support for the student. It is suggested to start small and build off of positive experiences with the realization that brain injured people commonly do not fully recognize their deficits. A beneficial home environment is encouraged and described as calm and relaxing, in order to allow for as much rest as possible.